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malocclusion refers to the misalignment of teeth and/or
incorrect relation between the teeth of the two dental
arches.
Malocclusions
may be coupled with skeletal disharmony of the face,
where the relations between the upper
and lower jaws are not appropriate. In these cases
the dental problem is, most of the time, derived from
the skeletal disharmony. Next, some
of the most common malocclusions:
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Lack
of space:
Crooked
or crowded teeth is the most frequent orthodontic
problem. There are many factors that contribute
to the develpment of this problem, but it can
be easily described as an excess of dental
(teeth) structure, compared to a less developed
bone arch (maxilla or mandible).
Besides
compromising a beautifull smile, crooked teeth
make brushing and flossing more difficult
which deteriorate the gingival health. Periodontitis
is a major side effect of severe crooked teeth. |
Spaces
Spaces between the teeth can compromise the hygiene
and be a distraction
to the person you are speaking with. It
can divert that person's attention from your face to
that defect, since it is always associated to an
unesthetic smile.
The cause of spacing may be heredity
or some personal habit like tongue thrusting, thumb
sucking, abnormal swallowing, etc. Another cause in
adults is advanced gum disease, leading to loss of
supporting bone and the teeth spreading out. The cause
of the spacing can determine the technique used for
correction.
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Class
I
Here the molar relationship of the occlusion
is normal or as described for the maxillary
first molar, but the other teeth have problems
like spacing, crowding, over or under eruption,
etc
Many
Class I patients present a biprotrusion and
despite their correct molar occlusion, excrations
are preconized to correct a protruded profile.
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Class
II
In this situation, the upper molars are placed not in the mesiobuccal
groove but anteriorly to it. Usually the mesiobuccal cusp rests in between
the first mandibular molars and second premolars.
There
are two subtypes:
Class II Division 1: The molar relationships
are like that of Class II and the anterior
teeth are protruded.
Class II Division 2: The molar relationships
are class II but the central are retroclined
and the lateral teeth are seen overlapping
the centrals.
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Class
III
Is when the lower front teeth are more prominent than the upper front
teeth. In this case the patient has very often a large mandible or a
short maxillary bone.
In
this situation, the upper molars are placed
not in the mesiobuccal groove but posteriorly
to it.
In
adult patiets, orthognatic surgery may be the
best choice of treatment.
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Deep
bite
A deep or excessive overbite
happens when the lower incisors bite too closely
to or into the gum tissue or palate behind
the upper teeth.
Excessive
overbite may be caused by disproportionate
eruption of front teeth, or over development
of the bone that supports the teeth. Excessive
overbite is commonly seen in conjunction with
a Class II relationship.
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Open
bite
An anterior open bite is when the anterior
(front) teeth do not touch. This does not occur
naturally because teeth constantly erupt during
their lifetime.
In
most cases, an anterior tongue thrust causes
an
anterior open bite. The tongue is extremely
strong and when it gets between the upper and
lower teeth, this strong muscle pushes the teeth
back into their sockets. The result is that the
teeth do not touch and remain open even when
the rest of the teeth close. Thumb sucking can
also cause this problem. Additionally,
thumb sucking and
other oral
habits
when done
constantly can create an opening.
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Crossbite
Crossbite is an occlusal irregular condition where
a lower tooth has a more buccal position than the
antagonist upper tooth. Crossbite can involve a
single tooth or a group of teeth. It can be classified
in anterior or posterior. Anterior cross bite can
also be referred as negative overjet, and is typical
of class III skeletal relations. Posterior
crossbite is often correlated to a narrow maxilla
and upper dental arch. A posterior cross-bite can
be unilateral or bilateral. Unilateral cross-bite
often determines a lateral shift of the mandibular
position.
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Temporomandibular
disorders
Temporomandibular joint dysfunction is known by several
names and acronyms such as Myofascial Pain Disorder (MPD),
Craniomandibular Joint Disorder, or most commonly just
as "TMJ". Basically it is caused when the improper
relationship of the jaws causes the chronic degeneration
of the temporomandibular joint resulting in pain, tension
or spasms of the muscles of the head, neck and/or jaw.
TMD
can be seen in teenagers as well as senior citizens
and all ages in between. It
can be manifested as severe, acute pain, chronic discomfort,
or sometimes simply as grinding or clenching. Often patients
suffering from TMJ have seen several doctors and other
health care providers such as physical therapists, chiropractors
and massage therapists and found little improvement because
the malocclusion has not been corrected. Sometimes, orthodontics
treatment can help diminish the main TMD symptoms.
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